Request an Appointment Request an Appointment Is this your first visit to the clinic? Yes No Name(Required) First Last Phone(Required)Email(Required) Enter Email Confirm Email Which doctor would you like to see? Dr. Tammy Gracen Dr. Daniel Halayko Either doctor Requested Appointment Date Requested Appointment Time Hours : Minutes AM PM AM/PM Tell us a summary about your condition(Required) If you are a new patient, please download this intake form, fill it in and bring it to your first appointment